title: [Recent outcomes of open total arch repair using selective cerebral perfusion with some technical improvement].
abstract: OBJECTIVE
  Recently, some technical improvements in aortic arch repair have brought better outcomes. In this article, we reviewed our surgical results of open arch repair using selective cerebral perfusion(SCP).
  
  
  METHODS
  Between 2001 and 2012, a total of 813 patients (median age of 70 years) underwent total arch replacement with SCP. We preferably use the right axillary artery cannulation for SCP and stepwise technique for distal anastomosis. The temperature at hypothermic circulatory arrest was moder ate in 46%, and deep in 54%.Of them, 22% had emergency surgery.
  
  
  RESULTS
  Early mortality was 5.2% in all. The incidences of permanent( PND) and temporary neurological deficits were 3.4% and 7.3%. No spinal cord injury occurred, even with moderate hypothermia. The cumulative survival rates were 78.4% and 49.9% at 5 and 10 years, respectively. The freedom from arch reoperation was 98.0% and 96.2% at 5 and 10 years, respectively.
  
  
  CONCLUSIONS
  Open total arch replacement using selective cerebral perfusion with some technical improvement provides favorable outcome, even in long-term period.
authors.affiliation: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iba
authors.forename: Kenji
authors.initials: K
authors.lastname: Minatoya
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Matsuda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Saito
authors.forename: Junpei
authors.initials: J
authors.lastname: Kobiki
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002560:Cerebrovascular Circulation; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods*; D055815:Young Adult